# DECATUR MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Professional Fees
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477276301
- **Authorized official:** JUDI L HARLAN (NETWORK DEVELOPMENT AND PARTNERSHIP)
- **Authorized official phone:** (217) 588-2882

## Contact information

- **Practice address:** 2300 N EDWARD ST, DECATUR, IL 62526-4192
- **Practice address phone:** (217) 876-8121
- **Mailing address:** 2300 N EDWARDS ST, MEDICAL STAFF OFFICE, DECATUR, IL 62526
- **Mailing address phone:** (217) 876-2857

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 09/26/2022
- **Last updated:** 09/27/2022